The applicant have a unique background that combines clinical training in general pediatrics and graduate health services research training through the Robert Wood Johnson Clinical Scholars Program. His past research efforts have been focused on studying health care disparities in children. His past training and education have developed research skills in quantitative and statistical methods, along with clinical insights into the care delivery process. Through the proposed career development activities, the applicant seeks to acquire new skills in qualitative methods such as focus groups and interviews that can compliment his existing research skills in order to better study health care disparity in children. The proposed career development activities consist of: 1) formal education through a thoughtfully selected curriculum of courses on qualitative methods, pediatric health services research, research ethics, and advance biostatistical analysis; 2) committed mentoring by a group of accomplished scholars and researchers in the field of pediatric health services research and health care disparity; 3) guidance and support from a multidisciplinary advisory committee; and 3) scheduled national meetings and seminars. The proposed research is aimed at examining social and cultural factors associated with disparities in access to care among a group of vulnerable children, children with chronic illnesses and special health care needs. The applicant believes that access to care in this population is important and under-addressed. The research plan consists of two phases and a formative research phase. Each subsequent phase builds upon the former. Phase I is secondary data analysis of the 2001 National Survey of Children with Special Health Care Needs (CSHCN). The analytical model for Phase I will be based on a conceptual framework derived from detailed literature review. The goal of Phase I consist of the identification of factors that can impact access to care for CSHCN, and characterize these factors. At the completion of Phase I, relevant findings will be used to guide the formative research phase, which will explore in more detail factors identified in Phase I and other candidate factors based on the conceptual model. Phase II is the development of an access-to-care survey instrument and limited-scope primary data collection to further examines factors impacting access to care for CSHCN. [unreadable] [unreadable]